Health Encyclopedia

Gonococcal arthritis

Definition

Gonococcal arthritis is inflammation of a joint (usually just one) due to a gonorrhea infection.

Alternative Names

Disseminated gonococcal infection (DGI)

Causes, incidence, and risk factors

Gonococcal arthritis is a bacterial infection of a joint that occurs in people who have gonorrhea. It affects women four times more often than men, and is most common among sexually active adolescent girls.

Two forms of gonococcal arthritis exist:

One involves skin rashes and multiple joints, usually large joints such as the knee, wrist, and ankle
The second, less common form involves disseminated gonococcemia, which leads to infection of a single joint

Symptoms

Fever
Lower abdominal pain
Migrating joint pain for 1 to 4 days
Pain in the hands or wrists due to tendon inflammation
Pain or burning on urination
Single joint pain
Skin rash (lesions are flat, pink to red, may later contain puss or appear purple

Signs and tests

Blood cultures should be checked in all cases of possible gonococcal arthritis.

Tests will be done to check for a gonorrhea infection. This may involve taking samples of tissue, stool, joint fluids, or other body material and sending them to a lab for examination under a microscope. Examples of such tests include:

Treatment

The gonorrhea infection must be treated. For detailed information about treating this disease, see: Gonorrhea

There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate, test, and treat all sexual contacts of the infected person, to prevent further spread of the disease.

A new standardized treatment routine is recommended by the Centers for Disease Control and Prevention (CDC). Your health care provider will determine the best and most up-to-date treatment. A follow-up visit 7 days after treatment is important to recheck blood tests and confirm the cure of infection.

Expectations (prognosis)

Symptoms usually improve within 1 to 2 days of starting treatment. Full recovery can be expected.

Complications

Untreated, this condition may lead to persistent joint pain.

For information on other gonorrhea-related complications, see: gonorrhea.

Calling your health care provider

Call your health care provider if you have symptoms of gonococcal arthritis.

Prevention

Not having sexual intercourse (abstinence) is the only absolute method of preventing gonorrhea. A monogamous sexual relationship with an individual known to be free of any sexually transmitted disease (STD) can reduce risk. Monogamous means you and your partner do not have sex with any other persons.

You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time.

References

Centers for Disease Control and Prevention (CDC). Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2006: Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections. MMWR. 2007; 56(14);332-336.

U.S. Preventive Services Task Force. Screening for Gonorrhea: Recommendation Statement. Am Fam Physician. Nov. 1, 2005; 72(9); 1783-1786.

Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004:2173-2186.

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2004. Atlanta, GA: U.S. Department of Health and Human Service, September 2005.

Weinstock H, Berman S, Cates W. Sexually transmitted disease among American youth: Incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004; 36: 6-10.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2002. MMWR. 2002;51(no. RR-6).

Review Date:12/3/2007
Reviewed By:D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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